Lactose intolerance and a dairy-free diet have become commonly mentioned terms in recent years but were practically unheard of in days gone by, for example during the 1950s and 60s when every school child was given a small bottle of milk each day for strong bones and teeth.  Whilst there may be different reasons for people to stop consuming dairy products, whether it be due to intolerance or dietary preferences, such as wishing to become vegan and abstain from all animal produce, the question remains as to how they will obtain their dietary calcium if not from this generally easily-available source.

Around the World

It is interesting to bear in mind that a large proportion of the world population consumes little or no dairy from the time they are weaned off breastmilk or formula milk. This includes most of China and South East Asia.  With the Westernisation of the Chinese diet, their consumption of dairy products is rapidly increasing and China is now one of the leading producers of milk products, although much of that is intended for export and not national consumption alone.

As we are frequently told that eating plenty of dairy will make our bones and teeth strong, this leads us to wonder how numerous generations of these populations managed to keep healthy without dairy products as an element of their diets and what they ate instead.  Also, despite the high intake of dairy in the Western world, we still have increasing numbers of people developing osteoporosis and therefore the answer to good bone health doesn’t appear to lie simply in consuming large quantities of milk, cheese and yoghurt.

What do we need it for?

Calcium is the most abundant mineral in the human body with 99% of it being stored in bones.  As well as being essential for maintaining strong bones and teeth it is also needed for other vital functions such as muscle contractions and blood clotting.

Here’s a table showing some dairy and non-dairy sources of calcium. 

 

Non-dairy sources of calcium

Milligrams per 100 g serving

Dairy sources of calcium

Milligrams per 100 g serving

Kelp (seaweed)

1093

Cheddar cheese

750

Kale

249

Yoghurt

120

Almonds

234

Whole milk

118

Parsley

203

Cottage cheese

94

Brazil nuts

186

 

 

Watercress

151

Goat’s milk

129

Tofu

128

 

 

Figs (dried)

126

 

 

Sunflower seeds

120

 

 

Sesame seeds

110

 

 

Olives

106

 

 

Broccoli

103

 

 

Walnuts

99

 

 

Pecans

73

 

 

Peanuts

69

 

 

Romaine lettuce

68

 

 

Apricots (dried)

67

 

 

Swede

66

 

 

Black currants

60

 

 

Pumpkin seeds

51

 

 

Adapted from Murray M, Pizzorno J, Pizzorno L (2012) The Encyclopaedia of Healing Foods, Piatkus, Singapore, p.119

 

However, this isn’t simply a matter of comparing the numbers on the table.  In some foods the calcium is more easily used by the body, this is referred to as its bioavailability, and the major point in favour of the dairy sources is that their bioavailability of calcium is greater.  The other sources are still valid but you’d have to eat larger amounts of the foods to gain the benefit.

Then there’s the protein …

Dairy products often contribute to a person’s dietary protein, and this is particularly the case for many vegetarians, and so it’s important to consider where your protein is coming from.  It’s best to include a variety of protein sources, such as meat, fish, nuts, beans, tofu etc.

There are a few other things to bear in mind, such as phosphorus, magnesium and Vitamin D – it’s all about balance

Phosphorus is another essential mineral and one of its many functions is to aid calcium absorption.  However, the balance of phosphorus to calcium is important to maintain because if there is too much phosphorus in relation to calcium it causes calcium to be lost in the urine.  The amount of phosphorus in a regular size can of a cola-type drink is high, at approximately 500 mg with virtually no calcium to offset it, so you can imagine how regular consumption of this type of soft drink can quickly lead to loss of calcium, particularly for those who don’t consume much calcium in their diet.  It would be good to check for phosphoric acid before drinking soft drinks to avoid this effect – others which contain this ingredient also include Diet Coke, Pepsi and Dr Pepper.

Magnesium works closely with phosphorus and calcium and much of this is stored in the bones. Amongst its numerous functions, it is needed for muscle and nerve cells and energy production.  Once again balance is key, so it’s wise to eat plenty of foods containing magnesium such as kelp and other seaweeds, nuts and seeds, whole grains and brown rice.

Our main source of Vitamin D is from sunlight; the action of sunlight on our skin starts the process of producing Vitamin D in the liver and kidneys and one of the many functions of Vitamin D is to stimulate the absorption of calcium.  Food sources of Vitamin D include oily fish, eggs and fortified foods.  Cancer Research UK has teamed up with six other health organisations to produce a consensus statement about Vitamin D and safe sun exposure – look on their website for details: www.cancerresearchuk.org

So, is it safe to drop the dairy? 

From the list of foods on the table above, and this is by no means a complete list, it is possible to get calcium from non-dairy sources and of course generations of people managed with little or no dairy in their diets.  However, our modern diets are very different in a number of ways, for example:

Drinks such as Coca Cola and Pepsi didn’t exist, so frequent consumption of high levels of phosphorus without calcium to offset it was probably rare.

Their foods weren’t heavily processed in the way that ours are and the food was more likely to have been produced locally, and therefore the nutrient content was likely to have been much higher.

They were likely to have been far more physically active and, with regard to bone health, weight-bearing exercise is very important, i.e. bearing your own weight such as in walking, hiking, running, and games like squash and tennis. Even those of us who exercise regularly are likely to have a more sedentary lifestyle in general than many of our ancestors.

So, in my opinion, yes, it is possible to still be healthy without eating dairy products, but you do need to consider what you are eating and take the trouble to ensure you’re getting enough calcium from alternative sources.  Lifestyle issues are also important to consider, such as avoiding soft drinks containing phosphoric acid, trying to eat wholefoods as much as possible by cooking meals from scratch and avoiding processed food, and of course very regular weight-bearing exercise is an essential factor.

 

References

Calvo MS, Tucker KL (2013) Is phosphorus intake that exceeds dietary requirements a risk factor in bone health?  Annuls of the New York Academy of Sciences, 1301: 29-35

Cancer Research UK:    www.cancerresearchuk.org

Murray M, Pizzorno J, Pizzorno L (2012) The Encyclopaedia of Healing Foods, Piatkus, Singapore

Webb GP (2008) Nutrition: a health promotion approach, 3rd edn., Hodder Arnold, Spain, p.72

 

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